February 17, 2005
National Cancer Institute director outlines ambitious goals during Dana-Farber visit
NCI Director Andrew von Eschenbach, MD, addresses the audience at Dana-Farber earlier this month.
In a visit to Dana-Farber earlier this month, National Cancer Institute (NCI) Director Andrew von Eschenbach, MD, gave a panoramic view of research initiatives pointed toward his announced goal of eliminating suffering and deaths from cancer by 2015.
The future, he said, will see a reversal in the amount of research money spent on prevention versus treatment; the breakdown is now about 20 percent for prevention and 80 percent for therapies. "The fact that we've begun to understand both cancer at the fundamental level and interactions between a cancer cell and host is opening up opportunities to intervene that can truly be transformational," he told staff from the Dana-Farber/Harvard Cancer Center (DF/HCC) at a "town hall" meeting in the Smith Family Room.
The DF/HCC is one of 60 NCI-designated cancer centers, and von Eschenbach explained in his Feb. 7 talk that "we have many centers of excellence, but we have not fully capitalized on our ability to integrate them all into a cohesive network." This in mind, the NCI has launched an effort to link the centers with a biomedical informatics grid called (caBIG) to foster sharing of research ideas and findings among researchers. The NCI likens the grid, which would be open to anyone, to a "World Wide Web for cancer."
Von Eschenbach also described initiatives in nanotechnology — creating new diagnostic and treatment materials just a few atoms in size for placement inside the body; advanced imaging capabilities; improved screening for early cancer detection; and an era of "personalized oncology" using patients' genetic profiles. At the same time, the NCI is working to reduce ethnic and racial disparities in cancer care.
Von Eschenbach, a survivor of melanoma and prostate cancer who became head of the federal cancer agency in 2002, emphasized that cancer is "a family of diseases" and there will be "no single solution to the problem as a whole." He predicted a future "in which we can achieve at least an interim outcome — the elimination of suffering and death from the disease."
Promoting teamwork
Ironically, von Eschenbach's description of the many tasks ahead coincided with the release of the Bush Administration's federal budget proposal for FY 2006. The $4.84 billion allotment for the NCI is essentially the same as last year's, and in real terms amounts to a slight increase because of belt-tightening throughout the National Institutes of Health.
One change, he said, will be a drop in the percentage of individual research grants funded by the NCI. The current "payline" or funding rate for individual grants is 20 percent, he said, "but we will not be able to keep it there. There won't be the same degree of success in nurturing young and new investigators." An online NCI publication estimated that the so-called individual "R01 grant" payline would decrease to about 16 percent.
As a result, von Eschenbach advised Dana-Farber and other centers to emphasize teamwork. "I'd like to see cancer centers take a much more aggressive position on fostering team grants rather than independent investigator research," he said. "They need to take risks by bringing young investigators together as teams and encouraging them to share — knowing they will be recognized and rewarded for this."
